Modern (up-to-date) imaging techniques to evaluate cardiac chambers by transthoracic echocardiography
Kovács Attila1, Ágoston Gergely2
1Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
2Szegedi Tudományegyetem, Általános Orvostudományi Kar, Családorvosi Intézet, Szeged
Left atrial (LA) longitudinal strain is a novel parameter used for the evaluation of LA function with demonstrated prognostic value in several cardiac diseases. Its ability to quantify myocardial deformation accurately reflects the degree of structural alterations, myocardial fibrosis and chamber stiffness. The same benefits of longitudinal strain apply for the right ventricle as well. However, the complex geometry of the chamber often requires the use of 3D imaging. Left ventricular global longitudinal strain (GLS) detects subtle changes in myocardial function, often not quantifiable by left ventricular ejection fraction (LVEF) alone. It has been recently recognized that GLS has greater prognostic value than LVEF in several conditions like elevated LV filling pressure, heart failure and valvular heart diseases. The GLS derived parameter mechanical dispersion (MD) might indicate LV myocardial fibrosis, substrate for malignant arrhythmias. Of note, the highly accurate measurement of LV volumes and ejection fraction by 3D echocardiography may provide not just added diagnostic and prognostic value, but may be more cost-effective through the proper indication of specific cardiac therapies.